Many readers wrote to express distress about President Donald Trump’s executive order last week directing federal health officials to reduce the number of recommended vaccines for children from 18 to 11. The order also calls for the measles, mumps and rubella vaccine to be separated into three individual shots and for vaccinations to be spaced further apart.
Greg from North Carolina, who previously worked in pharmaceutical research, questioned whether the administration appreciates what it would take to carry out this directive. “I don’t think these people realize how complex [separating vaccines] would be. Drugmakers would have to produce vaccines that haven’t been marketed separately in decades and ramp up manufacturing to make many more individual doses. It would be extremely hard to get brand new vaccines out there.”
I agree, and I think that’s exactly the intended effect of the order. There are no individual vaccines against measles, mumps and rubella approved in the United States; the three-in-one MMR vaccine has been standard since the early 1970s. To bring back separate vaccines, manufacturers would have to conduct large studies demonstrating that each produces an immune response comparable to existing vaccines. Regulators would have to evaluate new manufacturing processes and license each vaccine separately. Companies may also need new production facilities, which can take years to build.
And this is before considering that states and medical societies have already broken with federal vaccine recommendations and will probably continue to do so. Insurers, hospitals and individual providers will have to decide which guidelines they align with. Adding this much complexity will make it harder for people to get vaccinated. It creates more confusion and will almost certainly further reduce vaccination rates.
Another reader, Isabel from New York, wondered whether policymakers are taking the financial consequences into account. “Has someone tried to calculate what it costs to contain an outbreak when these diseases come back?”
In fact, a recent report in the Annals of Internal Medicine examined precisely this question. Researchers calculated that containing a 2025 measles outbreak in New Mexico cost nearly $5.4 million. There were about 100 confirmed cases, so that works out for about $53,000 per case.
The total included not only medical care for infections but also costs associated with people who were exposed and quarantined and the public health workers who responded to the outbreak. As vaccine-preventable diseases increase around the country, these costs should be calculated and publicized.
“When will the updated [covid-19] vaccine become available this season? And flu?” asked Kate from Utah. She is among dozens of readers who have written with similar questions.
Maryellen from Virginia explained that she and her husband last received covid vaccines last September. “He is 85 years old, and I am 74,” she wrote. “With an upcoming family event in early September this year, should we get our covid booster now, with the same vaccination formulation as last year’s, or wait for the newer vaccine coming this fall?”
Carol from South Carolina had a similar question: “I am 77 years old and my 84-year-old husband and I are traveling to Greece for 10 days starting Sept. 21. We both had our covid booster last September. Is there an updated covid vaccine coming out this September 2026, or should we go ahead and get a second 2025-26 covid booster now?”
The answers to these questions are not straightforward. Here is what we know and what we can reasonably surmise:
The Food and Drug Administration has recommended that the 2026-27 covid vaccine target the XFG strain of the coronavirus. It has also selected the strains for the 2026-27 flu vaccine and just approved a new mRNA flu vaccine for people 50 and older.
What happens next is less clear. Normally, the Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention would review the evidence and make recommendations about who should receive the vaccines, which the CDC director would then consider. But a federal judge ruled in March that Health and Human Services Secretary Robert F. Kennedy Jr. did not follow required legal procedures when he summarily dismissed and replaced all of that committee’s members. Its June meeting was canceled, and the next one is not scheduled until October.
I reached out to HHS for clarity on what will happen in the meantime, including whether the new CDC director could issue recommendations without ACIP and when the updated vaccines are expected to become available. The department did not respond to my request for comment.
What should people make of this? The most reasonable course would be for the CDC to recommend covid and flu vaccination, as it has in previous years. But I don’t know when that will happen. If the FDA approvals go into effect before the CDC weighs in, the vaccines could become available before there is clear federal guidance.
This is not unprecedented. In fact, it happened last fall with the covid vaccine. The result was wildly different access by state and great confusion over insurance coverage. Many people encountered difficulties getting vaccinated.
For now, I think people have two options: Those who have upcoming travel or another reason to want additional protection in the next month can check whether the 2025-26 covid vaccine is still available at their pharmacy. If it is, getting it now makes sense, particularly for older adults and others at higher risk. If it is not easily available, waiting is also reasonable. I expect the 2026-27 vaccine will eventually become available, though there may be barriers to accessing it during the early part of the rollout.
I will continue following this issue and will update readers as soon as I have more information. In the meantime, I encourage everyone to make sure they are up-to-date on the vaccines that are available to them.
The resources I recommend are the adult immunization schedules developed by the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists, which were endorsed by the American College of Physicians. Families with children should follow the vaccination schedule recommended by the American Academy of Pediatrics.
The post Federal vaccine drama is causing great confusion. Your questions, answered. appeared first on Washington Post.
